title: Does estimated glomerular filtration rate have an effect on left ventricular function after ST-elevation myocardial infarction?
abstract: OBJECTIVE
  Little is known about whether estimated glomerular filtration rates (eGFR) affect left ventricular (LV) function and gain benefit with antiremodeling treatment in patients with ST-elevation myocardial infarction (STEMI). We investigated the effect of eGFR on LV function using tissue Doppler imaging (TDI) parameters. In addition, we sought to evaluate the antiremodeling effect of standard treatment at follow-up in patients with renal insufficiency (RI) after STEMI.
  
  
  RESULTS
  A retrospective analysis of 579 patients with STEMI was performed. Patients were divided into 3 groups according to eGFR (Group 1: eGFR > 90 mL/min per 1.73 m(2); Group 2: eGFR = 60-89 mL/min per 1.73 m(2); Group 3: eGFR < 60 mL/min per 1.73 m(2)). Conventional echocardiography and TDI were performed within 48-72 hours after STEMI and at 6-month follow-up. The mean left ventricular ejection fraction (LVEF) was significantly lower in Group 3 than in Group 1 (P = 0.021). The mean peak systolic velocity (Sm) was significantly lower in Group 3 than in Group 1 and Group 2 (P = 0.002 and 0.006, respectively). The estimated GFR had a linear association with Sm and LVEF (P = 0.001, r = 0.161; P = 0.005, r = 0.132, respectively). Multivariate analysis showed that an eGFR < 60 mL/min per 1.73 m(2) was an independent predictor of lower Sm and in-hospital mortality. In addition, an antiremodeling effect of standard treatment was seen in all groups at 6-month follow-up.
  
  
  CONCLUSIONS
  Estimated glomerular filtration rate of <60 mL/min per 1.73 m(2) was associated with lower LV function after STEMI, and may gain an antiremodeling effect with standard treatment at follow-up.
authors.affiliation: Cardiology Department, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Sonmez
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Vatankulu
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bacaksiz
authors.forename: Selim
authors.initials: S
authors.lastname: Ayhan
authors.forename: Hüseyin U
authors.initials: HU
authors.lastname: Yazici
authors.forename: Ekrem
authors.initials: E
authors.lastname: Karakaya
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozdogru
authors.forename: Nazif
authors.initials: N
authors.lastname: Aygul
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Ozdemir
authors.forename: Adnan
authors.initials: A
authors.lastname: Abaci
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D015331:Cohort Studies; D016001:Confidence Intervals; D017023:Coronary Angiography; D004452:Echocardiography / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D020257:Ventricular Remodeling / Q000502:physiology
keywords: acute myocardial infarction; glomerular filtration rate; left ventricle remodeling; renal insufficiency; tissue Doppler